“We have bro­ken bar­ri­ers in car­dio­vas­cu­lar care with many ground­break­ing firsts”, shares Dr Ris­shi Ram­per­sad, In­ter­ven­tion­al Car­di­ol­o­gist, Caribbean Heart Care Med­corp (CHCm).

The in­sti­tu­tion was cre­at­ed in 1993 in re­sponse to the in­creas­ing chal­lenges of car­dio­vas­cu­lar dis­ease with­in Trinidad and To­ba­go. Dr Ka­mal Ram­per­sad en­gaged a group of heart care spe­cial­ists, led by Pro­fes­sor An­geli­ni from Bris­tol Heart In­sti­tute, to es­tab­lish a pro­gramme of open heart surgery at the Er­ic Williams Med­ical Sci­ence Com­plex. Es­tab­lish­ing this pro­gramme re­quired per­son­al sac­ri­fice. At home we gave up our beds to ac­com­mo­date these pro­fes­sion­als. I saw the pas­sion with which they em­braced the chal­lenge, rush­ing in and out of our home at un­usu­al hours to at­tend to pa­tients.

Ground­break­ing Firsts

At Caribbean Heart Care Med­corp, ini­tial­ly we re­lied on the ex­per­tise of for­eign pro­fes­sion­als while es­tab­lish­ing a rig­or­ous train­ing pro­gramme for our na­tion­als. By 2005 we de­vel­oped the first heart at­tack unit which still op­er­ates to­day. These ground­break­ing firsts in­clude the first aneurysm treat­ment in 2005, re­place­ment of heart valves, the first re­place­ment of heart valve with­out open heart surgery (TAVR) 2015, and the first 2000 open heart surg­eries in the Caribbean. All these were done in an in­ter­na­tion­al­ly recog­nised en­vi­ron­ment ac­cred­it­ed for qual­i­ty, as­sess­ment, and con­tin­u­ous im­prove­ment. We main­tain these in­ter­na­tion­al stan­dards to to­day and hope it can be con­ta­gious with­in the en­tire Health­care fra­ter­ni­ty.

Lifestyle is the Pri­ma­ry Risk Fac­tor

Our lifestyles are pri­ma­ry con­trib­u­tors to risk fac­tors. From ear­ly child­hood our di­ets are loaded with food filled with sat­u­rat­ed fat, sug­ar lad­ed soft drinks and juice. We al­so lead seden­tary lifestyles hooked on elec­tron­ic de­vices and tele­vi­sion while feast­ing on fried foods and processed meals. Di­et and lack of ex­er­cise are ma­jor con­trib­u­tors to the ear­ly on­set of di­a­betes, hy­per­ten­sion, and high cho­les­terol. We need to teach our chil­dren and our chil­dren’s chil­dren, about healthy lifestyles, and car­dio­vas­cu­lar pre­ven­tion in or­der to live op­ti­mised lives and to cre­ate a fu­ture of a health­i­er Trinidad and To­ba­go. Caribbean Heart Care Med­corp par­tic­i­pates at both spec­trums, pre­ven­ta­tive via Health Ed­u­ca­tion pro­grammes and Restora­tive, time­ly in­ter­ven­tion­al re­sponse and sur­gi­cal re­pair.

Da­ta pro­vide ev­i­dence of our suc­cess

Two decades of Da­ta com­pi­la­tion in­di­cate that CHCm is one of the best car­dio­vas­cu­lar surgery units in the world, right here in Trinidad and To­ba­go. Our mor­tal­i­ties are low com­pared to the in­ter­na­tion­al da­ta and we have es­tab­lished our­selves as a lo­cal train­ing in­sti­tu­tion for ex­perts in car­di­ol­o­gy. When pa­tients ask “Doc, am I go­ing to live through this surgery?” we con­fi­dent­ly re­fer to the da­ta. Ad­di­tion­al­ly, we have per­formed over 15,000 an­giograms and over 60,000 car­diac pro­ce­dures and con­sul­ta­tions. This rep­re­sents well over 5% of our na­tion­al pop­u­la­tion.

CHCm is ho­n­oured to be the on­ly car­dio­vas­cu­lar in­sti­tu­tion to have re­ceived the QHA Trent Hos­pi­tal Ac­cred­i­ta­tion in the Caribbean. We are dri­ven to main­tain the ex­cel­lence re­quired by this award. We strive to com­ple­ment com­pas­sion and care for pa­tients and their fam­i­lies with a team of high­ly ex­pe­ri­enced med­ical per­son­nel.

Swift Re­sponse Saves Lives

By 2005, the first heart at­tack unit re­quired a team of car­diac nurs­es, doc­tors and tech­ni­cians to be on call 24 hours, sev­en days a week. Da­ta in­di­cate that many heart at­tacks oc­cur ear­ly in the morn­ing. I re­mem­ber hav­ing to go out in the ear­ly morn­ings with this team who have be­come like fam­i­ly, work­ing in bat­tle to save a pa­tient’s life. This al­lowed us to treat some­one with a heart at­tack with­in min­utes; high­ly favourable out­come with­in in­ter­na­tion­al stan­dards and guide­lines.

Re­spond­ing swift­ly af­ter a heart at­tack, per­form­ing emer­gency an­gio­plas­ty and stent­ing with­in a crit­i­cal time frame, can save heart mus­cle and a life.

Our 24 hours, rapid re­sponse, pri­ma­ry an­gio­plas­ty, heart at­tack team, has been one of our not­ed ac­com­plish­ments over the last 15 years. Our high suc­cess rate and high­ly ex­pe­ri­enced team have saved hun­dreds of lives. While this is per­son­al­ly re­ward­ing, it has been quite hum­bling to work along­side these un­seen silent he­roes.

Ef­fi­cient Part­ner­ships Make a Dif­fer­ence

CHCm has worked close­ly in a pub­lic/pri­vate part­ner­ship with the Min­istry of Health, Trinidad and To­ba­go for more than 18 years. We both ap­pre­ci­ate the sever­i­ty of Coro­nary artery dis­ease in our coun­try. We have per­formed thou­sands of an­giograms and an­gio­plas­ties. We thank the MOH for this col­lab­o­ra­tion. Through chal­leng­ing times over the years, fi­nan­cial and oth­er­wise, we have re­mained dis­ci­plined and fo­cused on our mis­sion to save lives. CHCm has even as­sist­ed in train­ing nurs­es to be sta­tioned in To­ba­go and al­so made sig­nif­i­cant in­puts in set­ting up To­ba­go’s first catheter­i­za­tion lab. As a re­sult of this lab the wait­ing time for a coro­nary an­giogram was re­duced to one week.

In­valu­able Lessons Learnt Over the Years

Qual­i­ty care and pas­sion for ser­vice com­ple­ment each oth­er. We con­stant­ly strive to im­prove and per­form with ex­cel­lence. Treat­ing pa­tients brings med­i­cine, com­pas­sion, and em­pa­thy to­geth­er. It is your bed­side man­ners; the in­to­na­tion of your speech. It is some­times the un­spo­ken con­cern; some­thing that is not al­ways prac­ticed in the health­care in­dus­try to­day. It is an ho­n­our to serve pa­tients in this no­ble pro­fes­sion. We are thank­ful for those who ex­press their ap­pre­ci­a­tion. We were hum­bled to re­ceive the 2013 award for ser­vice provider of the year from the Trinidad and To­ba­go Coali­tion Ser­vice In­dus­try.

We all have per­son­al sto­ries. In 2006, I re­mem­bered one of my se­nior doc­tors in the SCMC ICU at­tend­ing to a tall, mus­cu­lar guy who had just re­ceived a life-sav­ing an­gio­plas­ty fol­low­ing a mas­sive heart at­tack. The pa­tient was anx­ious and scared in his bed. His blood pres­sure was high and his heart was rac­ing. I re­mem­ber that this doc­tor took his hand and be­gan gen­tly touch­ing this guy on his head like a moth­er strokes a ba­by’s head. While look­ing at the mon­i­tors we no­ticed his pulse rate drop and blood pres­sure be­gan to nor­mal­ize. The doc­tor’s demon­stra­tion of com­pas­sion for this pa­tient was al­most mirac­u­lous. This was a last­ing les­son for me. To this date, I en­sure that all our doc­tors, stu­dents and nurs­es that work with CHCm pa­tients ex­em­pli­fy this qual­i­ty of Com­pas­sion­ate pa­tient cen­tred care.